Surgical instrument for transmitting energy to tissue comprising a movable electrode or insulator

ABSTRACT

A surgical instrument for supplying energy to tissue can comprise a jaw member comprising an electrode, wherein the electrode is configured to generate heat when electrical energy is supplied to the electrode, and wherein the electrode comprises a top surface. The surgical instrument can further comprise an insulator positioned adjacent to the electrode, wherein the insulator comprises a top surface movable between a first position and a second position relative to the top surface of the electrode, and wherein the top surface of the insulator is closer to the top surface of the electrode when the insulator is in the first position than when the insulator is in the second position.

BACKGROUND

i. Field of the Invention

The present invention is directed to surgical instruments and methodsfor the use thereof.

ii. Description of the Related Art

In various circumstances, a surgical instrument can be configured toapply energy to tissue in order to treat and/or destroy the tissue. Incertain circumstances, a surgical instrument can comprise one or moreelectrodes which can be positioned against and/or positioned relative tothe tissue such that electrical current can flow through the electrodesand into the tissue. The surgical instrument can further comprise anelectrical input, a supply conductor electrically coupled with theelectrodes, and/or a return conductor which can be configured to allowcurrent to flow from the electrical input, through the supply conductor,through the electrodes and tissue, and then through the return conductorto an electrical output, for example. In various circumstances, thecurrent can generate heat within the electrodes wherein the heat cancreate one or more hemostatic seals within the tissue. Such embodimentsmay be particularly useful for sealing blood vessels, for example. Thesurgical instrument can further comprise a cutting member which can bemoved relative to the tissue and electrodes in order to transect thetissue.

The foregoing discussion is intended only to illustrate various aspectsof the related art in the field of the invention at the time, and shouldnot be taken as a disavowal of claim scope.

SUMMARY

In at least one form, a surgical instrument can comprise an end effectorcomprising an electrode and a cutting member. The surgical instrumentcan further comprise an elongate shaft comprising a proximal end and adistal end, wherein said end effector is coupled to said distal end ofsaid elongate shaft, and wherein said elongate shaft further comprises aconductor electrically coupled with said electrode. The surgicalinstrument can further comprise a drive shaft operably coupled with saidcutting member. The surgical instrument can further comprise a handlecoupled to said proximal end of said elongate shaft, wherein said handlecomprises a lock movable between a locked position and an unlockedposition, wherein said lock is engaged with said drive shaft to preventsaid drive shaft from being advanced toward said distal end of saidelongate shaft when said lock is in said locked position, and whereinsaid lock is disengaged from said drive shaft to permit said drive shaftto be advanced toward said distal end of said elongate shaft when saidlock is in said unlocked position. The handle can further comprise anelectrical input, and a switch movable between an unactuated positionand an actuated position, wherein said electrical input is electricallyuncoupled from said conductor when said switch is in said unactuatedposition, wherein said switch is configured to electrically couple saidelectrical input and said conductor when said switch is in said actuatedposition, and wherein said switch and said lock are operably coupledsuch that the movement of said switch from said unactuated position tosaid actuated position moves said lock from said locked position to saidunlocked position.

In at least one form, a surgical instrument can comprise an end effectorcomprising an electrode and a cutting member, and an elongate shaftcomprising a proximal end and a distal end, wherein said end effector iscoupled to said distal end of said elongate shaft, and wherein saidelongate shaft further comprises a conductor electrically coupled withsaid electrode. The surgical instrument can further comprise a driveshaft operably coupled with said cutting member. The surgical instrumentcan further comprise a handle coupled to said proximal end of saidelongate shaft, wherein said handle comprises a lock movable between alocked position and an unlocked position, wherein said lock is engagedwith said drive shaft to prevent said drive shaft from being advancedtoward said distal end of said elongate shaft when said lock is in saidlocked position, and wherein said lock is disengaged from said driveshaft to permit said drive shaft to be advanced toward said distal endof said elongate shaft when said lock is in said unlocked position. Thehandle can further comprise an electrical input, and a switch movablebetween an unactuated position and an actuated position upon theapplication of a first force to said switch, wherein said electricalinput is electrically uncoupled from said conductor when said switch isin said unactuated position, wherein said switch is configured toelectrically couple said electrical input and said conductor when saidswitch is in said actuated position, wherein said switch and said lockare operably coupled such that a second force applied to said switchmoves said lock from said locked position to said unlocked position, andwherein said second force is larger than said first force.

In at least one form, a surgical instrument can comprise an end effectorcomprising an electrode and a cutting member, and an elongate shaftcomprising a proximal end and a distal end, wherein said end effector iscoupled to said distal end of said elongate shaft, and wherein saidelongate shaft further comprises a conductor electrically coupled withsaid electrode, and a drive shaft operably coupled with said cuttingmember. The surgical instrument can further comprise a handle coupled tosaid proximal end of said elongate shaft, wherein said handle comprisesa lock movable between a locked position and an unlocked position,wherein said lock is engaged with said drive shaft to prevent said driveshaft from being advanced toward said distal end of said elongate shaftwhen said lock is in said locked position, and wherein said lock isdisengaged from said drive shaft to permit said drive shaft to beadvanced toward said distal end of said elongate shaft when said lock isin said unlocked position. The handle can further comprise an electricalinput, and a switch movable between an unactuated position, an actuatedposition, and a third position, wherein said electrical input iselectrically uncoupled from said conductor when said switch is in saidunactuated position, wherein said switch is configured to electricallycouple said electrical input and said conductor when said switch is insaid actuated position, and wherein said switch and said lock areoperably coupled such that the movement of said switch from saidactuated position to said third position moves said lock from saidlocked position to said unlocked position.

In at least one form, a surgical instrument for supplying energy totissue can comprise a handle comprising a trigger and an electricalinput, and a shaft extending from said handle, wherein said shaftcomprises a conductor, and wherein said trigger is selectivelyactuatable to electrically couple said electrical input and saidconductor. The surgical instrument can further comprise an end effectorcomprising a first jaw member and a second jaw member, wherein at leastone of said first jaw member and said second jaw member is movablerelative to the other of said first jaw member and said second jawmember to clamp tissue intermediate said first jaw member and saidsecond jaw member. The end effector can further comprise an electrodeelectrically coupled with said conductor, wherein said electrode isconfigured to generate heat when electrical energy is supplied to saidelectrode, and at least one steam path within said electrode, whereinsaid at least one steam path is configured to vent steam generated whenthe tissue is heated by the electrode.

In at least one form, a surgical instrument for supplying energy totissue can comprise a handle comprising a trigger and an electricalinput, and a shaft extending from said handle, wherein said shaftcomprises a conductor, and wherein said trigger is selectivelyactuatable to electrically couple said electrical input and saidconductor. The surgical instrument can further comprise an end effectorcomprising a first jaw member and a second jaw member, wherein at leastone of said first jaw member and said second jaw member is movablerelative to the other of said first jaw member and said second jawmember to clamp tissue intermediate said first jaw member and saidsecond jaw member. The end effector can further comprise an electrodeelectrically coupled with said conductor, wherein said electrode isconfigured to generate heat when electrical energy is supplied to saidelectrode, a return electrode electrically coupled with said returnconductor, and at least one steam path within said return electrode,wherein said at least one steam path is configured to vent steamgenerated when the tissue is heated by the electrode.

In at least one form, a surgical instrument for supplying energy totissue can comprise a handle comprising a trigger and an electricalinput, and a shaft extending from said handle, wherein said shaftcomprises a conductor, and wherein said trigger is selectivelyactuatable to electrically couple said electrical input and saidconductor. The surgical instrument can further comprise an end effectorcomprising a first jaw member and a second jaw member, wherein at leastone of said first jaw member and said second jaw member is movablerelative to the other of said first jaw member and said second jawmember to clamp tissue intermediate said first jaw member and saidsecond jaw member. The end effector can further comprise an electrodeelectrically coupled with said conductor, wherein said electrode isconfigured to generate heat when electrical energy is supplied to saidelectrode, and steam conduction means for conducting steam generatedwhen the tissue is heated by the electrode.

In at least one form, a surgical instrument for supplying energy totissue can comprise a handle comprising a trigger and an electricalinput, and a shaft extending from said handle, wherein said shaftcomprises a conductor, and wherein said trigger is selectivelyactuatable to electrically couple said electrical input and saidconductor. The surgical instrument can further comprise an end effectorcomprising a first jaw member and a second jaw member, wherein at leastone of said first jaw member and said second jaw member is movablerelative to the other of said first jaw member and said second jawmember to clamp tissue intermediate said first jaw member and saidsecond jaw member. The end effector can further comprise an electrodeelectrically coupled with said conductor, wherein said electrode isconfigured to generate heat when electrical energy is supplied to saidelectrode, and a tissue-grasping portion comprising a plurality ofteeth, wherein said tissue-grasping portion is comprised of anelectrically non-conductive material.

In at least one form, a surgical instrument for supplying energy totissue can comprise a handle comprising a trigger and an electricalinput, and a shaft extending from said handle, wherein said shaftcomprises a conductor, and wherein said trigger is selectivelyactuatable to electrically couple said electrical input and saidconductor. The surgical instrument can further comprise an end effectorcomprising a first jaw member and a second jaw member, wherein at leastone of said first jaw member and said second jaw member is movablerelative to the other of said first jaw member and said second jawmember to clamp tissue intermediate said first jaw member and saidsecond jaw member. The end effector can further comprise an electrodeelectrically coupled with said conductor, wherein said electrode isconfigured to generate heat when electrical energy is supplied to saidelectrode, and an array of electrically non-conductive teeth positionedadjacent to and extending away from said electrode.

In at least one form, a surgical instrument for supplying energy totissue can comprise a handle comprising a trigger and an electricalinput, and a shaft extending from said handle, wherein said shaftcomprises a conductor, and wherein said trigger is selectivelyactuatable to electrically couple said electrical input and saidconductor. The surgical instrument can further comprise a first jawmember comprising an electrode electrically coupled with said conductor,wherein said electrode is configured to generate heat when electricalenergy is supplied to said electrode, and wherein said electrodecomprises a top surface, and an insulator positioned adjacent to saidelectrode, wherein said insulator comprises a top surface movablebetween a first position and a second position relative to said topsurface of said electrode, and wherein said top surface of saidinsulator is closer to said top surface of said electrode when saidinsulator is in said first position than when said insulator is in saidsecond position. The surgical instrument can further comprise a secondjaw member, wherein at least one of said first jaw member and saidsecond jaw member is movable relative to the other of said first jawmember and said second jaw member to clamp tissue intermediate saidfirst jaw member and said second jaw member.

In at least one form, a surgical instrument for supplying energy totissue can comprise a handle comprising a trigger and an electricalinput, and a shaft extending from said handle, wherein said shaftcomprises a conductor, wherein said trigger is selectively actuatable toelectrically couple said electrical input and said conductor. Thesurgical instrument can further comprise a first jaw member comprisingan electrode electrically coupled with said conductor, wherein saidelectrode is configured to generate heat when electrical energy issupplied to said electrode, and wherein said electrode comprises a topsurface, and an insulator positioned adjacent to said electrode, whereinsaid insulator is movable relative to said tissue-contacting surfacebetween a first height and a second height, and wherein said insulatoris positioned closer to said tissue-contacting surface when saidinsulator is at said first height than when said insulator is at saidsecond height. The surgical instrument can further comprise a second jawmember, wherein at least one of said first jaw member and said secondjaw member is movable relative to the other of said first jaw member andsaid second jaw member to clamp tissue intermediate said first jawmember and said second jaw member.

In at least one form, a surgical instrument for supplying energy totissue can comprise a handle comprising a trigger and an electricalinput, and a shaft extending from said handle, wherein said shaftcomprises a conductor, and wherein said trigger is selectivelyactuatable to electrically couple said electrical input and saidconductor. The surgical instrument can further comprise a first jawmember comprising an electrode electrically coupled with said conductor,wherein said electrode is configured to generate heat when electricalenergy is supplied to said electrode, and wherein said electrodecomprises a top surface, and an insulator positioned adjacent to saidelectrode, wherein said insulator comprises a top surface, wherein saidtop surface of said electrode is movable between a first position and asecond position relative to said top surface of said insulator, andwherein said top surface of said electrode is closer to said top surfaceof said insulator when said electrode is in said first position thanwhen said electrode is in said second position. The surgical instrumentcan further comprise a second jaw member, wherein at least one of saidfirst jaw member and said second jaw member is movable relative to theother of said first jaw member and said second jaw member to clamptissue intermediate said first jaw member and said second jaw member.

In at least one form, a surgical instrument can comprise a handlecomprising a trigger movable between an unactuated position and anactuated position, a first drive system comprising a toggle clamp, and asecond drive system. The second drive system can comprise a rack, apinion operably engaged with said rack, and a yoke comprising a racklock selectively engageable with said rack, wherein said trigger ismovable between a first range of motion and a second range of motionwhen said trigger is moved between said unactuated position and saidactuated position, wherein said trigger is operably engageable with saidfirst drive system such that said trigger is configured to actuate saidtoggle clamp during said first range of motion, and wherein said triggeris operably engageable with said second drive system such that saidtrigger is configured to actuate said rack during said second range ofmotion. The surgical instrument can further comprise a shaft extendingfrom said handle, wherein said shaft comprises a knife bar movablebetween a first position, a second position, and a third position,wherein said toggle clamp and said rack are operably engageable withsaid knife bar, wherein said toggle clamp is configured to move saidknife bar between said first position and said second position, andwherein said rack is configured to move said knife bar between saidsecond position and said third position. The surgical instrument canfurther comprise an end effector extending from said shaft, wherein saidend effector comprises a distal end, a first jaw, and a second jaw,wherein said first jaw is movable relative to said second jaw between anopen position and a closed position, wherein said knife bar isconfigured to move said first jaw between said open position and saidclosed position when said knife bar is moved between said first positionand said second position, and wherein said knife bar is configured tomove toward said distal end of said end effector when said knife bar ismoved between said second position and said third position.

In at least one form, a surgical instrument configured to deliver energyto tissue can comprise a trigger movable between an unactuated positionand an actuated position, a first drive system comprising a toggleclamp, and a second drive system comprising a rack and pinion system,wherein said trigger is movable between a first range of motion and asecond range of motion when said trigger is moved between saidunactuated position and said actuated position, wherein said trigger isoperably engageable with said first drive system such that said triggeris configured to actuate said toggle clamp during said first range ofmotion, wherein said trigger is operably disengaged from said seconddrive system during said first range of motion, wherein said trigger isoperably engageable with said second drive system such that said triggeris configured to actuate said rack during said second range of motion,and wherein said trigger is operable disengaged from said first drivesystem during said second range of motion. The surgical instrument canfurther comprise a shaft extending from said handle, wherein said shaftcomprises a firing member movable between a first position, a secondposition, and a third position, wherein said toggle clamp and said rackare operably engageable with said firing member, wherein said toggleclamp is configured to move said firing member between said firstposition and said second position, and wherein said rack is configuredto move said firing member between said second position and said thirdposition. The surgical instrument can further comprise an end effectorextending from said shaft, wherein said end effector comprises a distalend, a first jaw, and a second jaw, wherein said first jaw is movablerelative to said second jaw between an open position and a closedposition, and wherein said firing member is configured to move saidfirst jaw between said open position and said closed position when saidfiring member is moved between said first position and said secondposition, and wherein said firing member is configured to move towardsaid distal end of said end effector when said firing member is movedbetween said second position and said third position.

The foregoing discussion should not be taken as a disavowal of claimscope.

FIGURES

Various features of the embodiments described herein are set forth withparticularity in the appended claims. The various embodiments, however,both as to organization and methods of operation, together withadvantages thereof, may be understood in accordance with the followingdescription taken in conjunction with the accompanying drawings asfollows.

FIG. 1 is a cross-sectional view of a handle of a surgical instrumentillustrated with some components removed in accordance with at least oneembodiment.

FIG. 2 illustrates the handle of FIG. 1 in an unactuated configurationwith various components removed.

FIG. 3 is an elevational view of an end effector of the surgicalinstrument of FIG. 1 illustrated in an open configuration and the distalend of a knife bar in an unadvanced position.

FIG. 4 illustrates a trigger and a first drive system of the handle ofFIG. 2 in a partially actuated configuration.

FIG. 5 is an elevational view of the end effector of FIG. 3 illustratedin a partially closed configuration and the knife bar of FIG. 3 in apartially advanced position.

FIG. 6 illustrates a toggle clamp of the first drive system of FIG. 4 ina completely actuated configuration.

FIG. 7 is an elevational view of the end effector of FIG. 3 illustratedin a fully closed configuration and the knife bar in a partiallyadvanced position.

FIG. 8 is a detail view of a yoke spring positioned intermediate a shaftof the surgical instrument of FIG. 1 and a yoke of the first drivesystem of FIG. 4.

FIG. 9 illustrates a lock system for locking and unlocking a seconddrive system of the handle of FIG. 2, wherein the lock system isillustrated in an unactuated and locked configuration. FIG. 9 furtherillustrates a portion of the first drive system of FIG. 4 in anunactuated configuration.

FIG. 10 illustrates the lock system of FIG. 9 in an actuated, but lockedconfiguration and the first drive system of FIG. 4 in an unactuatedconfiguration.

FIG. 11 illustrates the lock system of FIG. 9 in an actuated andunlocked configuration and the first drive system of FIG. 4 in anactuated configuration.

FIG. 12 illustrates the lock system of FIG. 9 in an unactuated andlocked configuration and the first drive system of FIG. 4 in an actuatedconfiguration.

FIG. 13 illustrates the lock system of FIG. 9 in an actuated andunlocked configuration and the first drive system of FIG. 4 in anactuated configuration.

FIG. 14 illustrates the lock system of FIG. 9 returned to a lockedconfiguration.

FIG. 15 illustrates the toggle clamp of the first drive system in acompletely actuated configuration and the trigger of FIG. 4 operablyengaged with a second drive system.

FIG. 16 illustrates a trigger gear portion of the trigger of FIG. 4operably engaged with a compound gear system of the second drive system.

FIG. 17 illustrates the end effector of FIG. 3 in a fully closedposition and the knife bar of FIG. 3 in a partially advanced position.

FIG. 18 illustrates the trigger of FIG. 4 in a fully actuated positionand a rack of the second drive system of FIG. 15 in a fully advancedposition.

FIG. 19 illustrates the end effector of FIG. 3 in a fully closedposition and the knife bar of FIG. 3 in a fully advanced positionproximal to a distal end of the end effector.

FIG. 20 is a detail view of the distal end of the end effector of FIG.19.

FIG. 21 illustrates a return plate of the handle of FIG. 2 operablyengaged with the trigger gear of FIG. 16. FIG. 21 also illustrates thetrigger of FIG. 4 and the rack of FIG. 18 in a partially retracted, orpartially returned, position.

FIG. 22 illustrates the trigger of FIG. 4 and the rack of FIG. 18 in afurther partially retracted, or further partially returned, position.

FIG. 23 illustrates the trigger of FIG. 4 engaged with the toggle clampof FIG. 6 and the toggle clamp being moved from its fully actuatedconfiguration to a partially actuated configuration. FIG. 23 alsoillustrates the rack of FIG. 18 in a further partially retracted, orfurther partially returned, position and the lock system of FIG. 9re-engaged with the rack of FIG. 18.

FIG. 24 illustrates the toggle clamp of FIG. 6 in a further partiallyactuated configuration and the rack of FIG. 18 in a further partiallyretracted, or further partially returned, position.

FIG. 25 illustrates the end effector of FIG. 3 in a partially openedposition and the knife bar of FIG. 3 in a partially retracted position.

FIG. 26 illustrates the toggle clamp of FIG. 6 in an unactuatedconfiguration.

FIG. 27 illustrates the end effector of FIG. 3 in a fully openedposition and the knife bar of FIG. 3 in a fully retracted position.

FIG. 28 illustrates the toggle clamp of FIG. 6 in an unactuatedconfiguration and the rack of FIG. 18 in a fully retracted position.

FIG. 29 is a perspective view of a handle of an alternative embodimentof a surgical instrument in an unactuated configuration illustrated withvarious components removed.

FIG. 30 is another perspective view of the handle of FIG. 29 in apartially actuated position illustrating a trigger coming into operativeengagement with a gear of a second drive system.

FIG. 31 is a perspective view of the lock system of FIG. 9 in anunactuated, but locked configuration with an alternative embodiment of arack of the second drive system.

FIG. 32 is an elevational view of the lock system of FIG. 9 in theunactuated, but locked configuration of FIG. 31. FIG. 32 furtherillustrates a button switch of the lock system in an unactuatedconfiguration.

FIG. 33 illustrates the button switch of FIG. 32 in an actuatedposition.

FIG. 34 illustrates the button switch of FIG. 32 in an actuatedposition, a link of the lock system in an actuated position, and thelock of the lock system in an unlocked position.

FIG. 34A is a detail view of the lock of FIG. 34 and a lock springconfigured to bias the lock into engagement with the rack.

FIG. 35 illustrates the lock system of FIG. 9 in an actuated, unlockedconfiguration and the rack of FIG. 31 in an unadvanced position.

FIG. 36 illustrates the lock system of FIG. 9 in an actuated, unlockedconfiguration and the rack of FIG. 18 in an unadvanced position.

FIG. 37 illustrates a jaw of an end effector in accordance with at leastone embodiment.

FIG. 38 illustrates a jaw of an end effector comprising steam controlpaths in accordance with at least one embodiment.

FIG. 38A is a cross-sectional view of the jaw of FIG. 38 illustratingthe steam control paths extending through an electrode of the endeffector. Various components of the end effector have been removed inFIG. 38A.

FIG. 38B is a cross-sectional view of a jaw of an alternative embodimentof an end effector illustrating steam control paths in supplyelectrodes, return electrodes, insulators positioned intermediate thesupply electrodes and the return electrodes, and a cutting membermovable within the end effector.

FIG. 39 illustrates a jaw of an end effector comprising a movableelectrode.

FIG. 40 illustrates a jaw of an end effector comprising first and secondinsulators which are movable relative to an electrode.

FIG. 41 illustrates a trigger assembly of an alternative embodiment of asurgical instrument, wherein the trigger assembly further comprises amechanism for limiting the force that can be transmitted through thetrigger assembly. FIG. 41 further illustrates a first part of thetrigger assembly (illustrated with phantom lines) moved relative to asecond part of the trigger assembly.

FIG. 42 is an elevational view of the first part of the triggerassembly.

FIG. 43 is an elevational view of the second part of the triggerassembly.

FIG. 44 illustrates a trigger assembly of an alternative embodiment of asurgical instrument, wherein the trigger assembly further comprises amechanism for limiting the force that can be transmitted through thetrigger assembly. FIG. 44 further illustrates a first part of thetrigger assembly (illustrated with phantom lines) moved relative to asecond part of the trigger assembly.

FIG. 45 is a diagram of an energy trigger assembly in accordance with atleast one alternative embodiment of the present invention.

FIG. 46 is a diagram of another energy trigger assembly in accordancewith at least one alternative embodiment of the present invention.

Corresponding reference characters indicate corresponding partsthroughout the several views. The exemplifications set out hereinillustrate various embodiments of the invention, in one form, and suchexemplifications are not to be construed as limiting the scope of theinvention in any manner.

DETAILED DESCRIPTION

Various embodiments are directed to apparatuses, systems, and methodsfor the treatment of tissue Numerous specific details are set forth toprovide a thorough understanding of the overall structure, function,manufacture, and use of the embodiments as described in thespecification and illustrated in the accompanying drawings. It will beunderstood by those skilled in the art, however, that the embodimentsmay be practiced without such specific details. In other instances,well-known operations, components, and elements have not been describedin detail so as not to obscure the embodiments described in thespecification. Those of ordinary skill in the art will understand thatthe embodiments described and illustrated herein are non-limitingexamples, and thus it can be appreciated that the specific structuraland functional details disclosed herein may be representative and do notnecessarily limit the scope of the embodiments, the scope of which isdefined solely by the appended claims.

Reference throughout the specification to “various embodiments,” “someembodiments,” “one embodiment,” or “an embodiment”, or the like, meansthat a particular feature, structure, or characteristic described inconnection with the embodiment is included in at least one embodiment.Thus, appearances of the phrases “in various embodiments,” “in someembodiments,” “in one embodiment,” or “in an embodiment”, or the like,in places throughout the specification are not necessarily all referringto the same embodiment. Furthermore, the particular features,structures, or characteristics may be combined in any suitable manner inone or more embodiments. Thus, the particular features, structures, orcharacteristics illustrated or described in connection with oneembodiment may be combined, in whole or in part, with the featuresstructures, or characteristics of one or more other embodiments withoutlimitation.

It will be appreciated that the terms “proximal” and “distal” may beused throughout the specification with reference to a clinicianmanipulating one end of an instrument used to treat a patient. The term“proximal” refers to the portion of the instrument closest to theclinician and the term “distal” refers to the portion located furthestfrom the clinician. It will be further appreciated that for concisenessand clarity, spatial terms such as “vertical,” “horizontal,” “up,” and“down” may be used herein with respect to the illustrated embodiments.However, surgical instruments may be used in many orientations andpositions, and these terms are not intended to be limiting and absolute.

The entire disclosures of the following commonly-owned, non-provisionalUnited States patent applications are hereby incorporated by referenceherein:

SURGICAL INSTRUMENT COMPRISING AN ENERGY TRIGGER LOCKOUT, filed on evendate herewith, Atty. Docket No. END6675USNP1/090329;

SURGICAL INSTRUMENT FOR TRANSMITTING ENERGY TO TISSUE COMPRISING STEAMCONTROL PATHS, filed on even date herewith, Atty. Docket No.END6675USNP4/090333;

SURGICAL INSTRUMENT FOR TRANSMITTING ENERGY TO TISSUE COMPRISINGNON-CONDUCTIVE GRASPING PORTIONS, filed on even date herewith, Atty.Docket No. END6675USNP2/090331; and

SURGICAL INSTRUMENT COMPRISING FIRST AND SECOND DRIVE SYSTEMS ACTUATABLEBY A COMMON TRIGGER MECHANISM, filed on even date herewith, Atty. DocketNo. END6675USNP/090330.

The entire disclosures of the following non-provisional United Statespatents are hereby incorporated by reference herein:

U.S. Pat. No. 7,381,209, entitled ELECTROSURGICAL INSTRUMENT;

U.S. Pat. No. 7,354,440, entitled ELECTROSURGICAL INSTRUMENT AND METHODOF USE;

U.S. Pat. No. 7,311,709, entitled ELECTROSURGICAL INSTRUMENT AND METHODOF USE;

U.S. Pat. No. 7,309,849, entitled POLYMER COMPOSITIONS EXHIBITING A PTCPROPERTY AND METHODS OF FABRICATION;

U.S. Pat. No. 7,220,951, entitled SURGICAL SEALING SURFACES AND METHODSOF USE;

U.S. Pat. No. 7,189,233, entitled ELECTROSURGICAL INSTRUMENT;

U.S. Pat. No. 7,186,253, entitled ELECTROSURGICAL JAW STRUCTURE FORCONTROLLED ENERGY DELIVERY;

U.S. Pat. No. 7,169,146, entitled ELECTROSURGICAL PROBE AND METHOD OFUSE;

U.S. Pat. No. 7,125,409, entitled ELECTROSURGICAL WORKING END FORCONTROLLED ENERGY DELIVERY; and

U.S. Pat. No. 7,112,201, entitled ELECTROSURGICAL INSTRUMENT AND METHODOF USE.

A surgical instrument can be configured to supply energy, such aselectrical energy and/or heat energy, for example, to the tissue of apatient. In various embodiments, referring now to FIG. 1, a surgicalinstrument, such as surgical instrument 100, for example, can comprise ahandle 102, a shaft 104, and an end effector 106 (FIG. 3). As describedin greater detail below, the handle 102 can comprise one or moreswitches or triggers which can be configured to supply electrical energyto end effector 106 and/or advance a knife or cutting member within theend effector 106, for example, in order to transect the tissuepositioned within the end effector 106.

In various embodiments, referring to FIG. 1, the handle 102 can compriseone or more electrical inputs, such as input, or terminal, 110, forexample, which can be operably coupled with a power supply, such as avoltage supply, for example. In various embodiments, such a power supplycan provide an electrical current to the surgical instrument 100,wherein the magnitude, duration, wave form, and/or frequency, forexample, of the current can be sufficiently controlled or modulated toprovide a desired amount of energy to the surgical instrument 100. Suchpower supplies are well known within the art and a more detaileddescription thereof is not required. In various embodiments, the handle102 can comprise a handle body 112 which, as described in greater detailbelow, can be configured to operably support a switch or trigger, suchas trigger system 120, for example, which can be configured toelectrically couple electrical input 110 with a conductor in shaft 104such that the current supplied to input 110 can be transmitted to endeffector 106. In various embodiments, referring to FIG. 1, handle body112 can comprise two portions which are assembled together to formhandle body 112. As the reader will note, only one of the portions, orhalves, is depicted in FIG. 1, although the other portion, or half, canbe a mirror image of, or at least substantially similar to, the halfdepicted in FIG. 1. In various embodiments, the halves of handle body112 can be snap-fit, press-fit, adhered, and/or fastened to one another.

In various embodiments, further to the above, the electrical conductorwithin the shaft 104 can comprise a wire, such as insulated wire, forexample, which can extend between trigger system 120 and an electrode130 (FIG. 3) in end effector 106. In certain embodiments, referringagain to FIG. 1, the handle 102 can further comprise a supply wire 114which can be electrically coupled with an electrical supply conductor(not illustrated) encased within an outer housing, or spine, 105 (FIG.8) of the shaft 104. In at least one embodiment, the supply conductorcan comprise a conductive insert, comprised of copper, for example,which is at least partially positioned within an insulative plasticjacket or sheath, for example, of the spine 105. In certaincircumstances, the plastic jacket can be molded over the conductiveinsert during an injection molding process. In various embodiments,referring again to FIG. 1, the handle 102 can comprise a slip ring 116which can be configured to electrically couple wire 114 with the supplyconductor within shaft 104. More particularly, in at least oneembodiment, the slip ring 116 can comprise a circular, or an at leastsemi-circular, contact, for example, mounted to handle body 102 whichcan remain in contact with a corresponding circular, or an at leastsemi-circular, contact mounted to shaft 104. Such corresponding contactscan permit relative rotational movement between shaft 104 and handle 102and yet still provide an electrical path between wire 114 and theelectrical supply conductor within shaft 104.

In various embodiments, the shaft 104 can further comprise another slipring connector which, similar to the above, can maintain electricalcontact between the supply conductor of shaft 104 and a supply contact132 (FIG. 3) of electrode 130. As described in greater detail below,electrical current can flow from the electrical input 110, throughsupply wire 114, through the electrical conductor in shaft 104, and intothe electrode 130 such that current can flow from the electrode 130 andinto the tissue captured within the end effector 106. In variousembodiments, as also described in greater detail below, the end effectorcan further comprise one or more return electrodes and/or conductorswhich can comprise a return path, or circuit, for the current. In atleast one embodiment, similar to the above, the return path can comprisea slip ring contact operably coupled with a return electrode in the endeffector 106 and a return conductor embedded within the shaft 104, forexample. Also similar to the above, the handle 102 can further comprisea slip ring 117, for example, which can maintain the return conductorwithin shaft 104 in electrical contact with return wire 115. In at leastone such embodiment, the return wire 115 can extend between the slipring 117 and an electrical output, or terminal, which can, in variousembodiments, be positioned adjacent to electrical input, or terminal,110.

Further to the above, referring to FIG. 37, an end effector 306 cancomprise an electrode 330 which can extend between a proximal end of endeffector 306 and a distal end 307 of end effector 306. In at least onesuch embodiment, the electrode 330 can comprise a first lateral portion331 extending along a first side of jaw member 334, a second lateralportion 333 extending along a second side of jaw member 334, and atransverse intermediate portion 335 connecting the first lateral portion331 and the second lateral portion 333. In various embodiments, furtherto the above, the first jaw member can further comprise a returnelectrode and/or the end effector can further comprise a second jawmember having a return electrode which can be positioned opposite thefirst jaw member. In any event, referring again to FIG. 1, the triggersystem 120 can comprise a button 122 which can be selectively actuatedin order to electrically couple the electrical input 110 with supplywire 114 and/or selectively actuated in order to electrically couple thereturn wire 115 with the electrical output of handle 102. Moreparticularly, in at least one embodiment, the button 122 can be movablebetween an undepressed, or unactuated, position in which current cannotflow to electrode 130, and a depressed, or actuated, position in whichcurrent can flow to electrode 130. Although the button 122, and/or anysimilar button, can be used to actuate the switch 123, and/or any othersuitable switch, other energy actuation mechanisms, such as toggles,levers, and/or any suitable actuators, can be used in addition to or inlieu of the above.

When electrical current is supplied to an electrode, referring again toFIG. 37, the electrical current can pass through the tissue positionedagainst and/or surrounding the electrode 330, for example. In variouscircumstances, the current flowing through the electrode 330 cangenerate heat within the electrode and the surrounding tissue. Incertain circumstances, the heat can denature the collagen within thetissue and, in co-operation with clamping pressure provided by the jawsof the end effector, the denatured collagen can form a seal within thetissue, for example. In at least one circumstance, the first side 331 ofelectrode 330 can be configured to create a first seal within the tissueand the second side 333 of electrode 330 can be configured to create asecond seal within the tissue. Other embodiments are envisioned in whichmultiple electrodes, and/or multiple electrode portions, can create anysuitable number of seals within the tissue. In various embodiments, asdescribed in greater detail below, one or more of the jaw members of anend effector can comprise grasping portions which can be utilized tomanipulate tissue within a surgical site and/or position and hold thetissue within the end effector.

In at least one embodiment, referring to FIG. 37, first jaw member 334can comprise at least one grasping member, such as a grasping portion337, for example, which can be comprised of an electricallynon-conductive, or insulative, material, such as plastic and/or ceramic,for example. In use, the grasping portions 337 can hold the tissuewithin the end effector without conducting, or at least notsignificantly conducting, current and/or heat to the tissue. In variousembodiments, as a result, the possibility of the treated tissue adheringto, or becoming stuck to, the grasping portions 337 can be reduced oreliminated. In various embodiments, each grasping portion 337 cancomprise an array or row of teeth 339, for example, wherein, in at leastone embodiment, a first grasping portion can comprise a first array orrow of teeth 339 and a second grasping portion can comprise a secondarray or row of teeth 339. In at least one such embodiment, the firstrow of teeth 339 can be positioned adjacent to the first lateral portion331 of electrode 330 and the second row of teeth 339 can be positionedadjacent to the second lateral portion 333 of electrode 330.

In various circumstances, further to the above, the grasping portions337 can be comprised of an electrically non-conductive plastic, glass,and/or ceramic, for example, and, in at least one embodiment, thegrasping portions 337 can be formed by an injection molding process. Incertain embodiments, at least one lubricant additive, such as Teflon,for example, can be mixed or embedded within the plastic. In variouscircumstances, the one or more lubricants can prevent, or at leastinhibit, the tissue captured within the end effector 306 from stickingor adhering to the teeth 339, for example. In addition to or in lieu ofthe above, in certain embodiments, at least one lubricant, such asTeflon, for example, can be coated on the grasping portions 337. Incertain embodiments, the grasping portions 337 can be comprised of anelectrically conductive material which can be coated, or at leastpartially coated, with an electrically non-conductive material, forexample

Owing to current flowing through the tissue and/or the heat generated bythe one or more electrodes of an end effector of the surgicalinstrument, water, and/or other fluids, within the tissue can bevaporized. In certain circumstances, the heated vapors, such as steam,for example, can flow out of the end effector and into the surgical sitesurrounding the end effector. In various circumstances, the heatedvapors can damage the surrounding tissue. In various embodiments,referring now to FIG. 38, at least one of the jaws, such as first jaw434, for example, of end effector 406 can comprise at least one steamcontrol path, passage, or conduit for conveying the steam, and/or othervapors created by the current and/or heat, away from the surgical site.In certain embodiments, an electrode, such as electrode 430, forexample, can comprise an electrode body and at least one steam controlpath therein. In at least one embodiment, referring to FIG. 38A, thesteam control path can comprise one or more passages 439 which canextend longitudinally through the first lateral portion 431 and thesecond lateral portion 433 of electrode 430, for example. The steamcontrol paths can further comprise one or more passages, or holes, 437which can extend between an outside surface of electrode 430 and thepassages 439 such that steam can flow from the tissue being treated,through the holes 437, and into the passages 439. In at least oneembodiment, the passage 439 extending though the first lateral portion431 and the passage 439 extending through the second lateral portion 433can be in fluid communication via a passage within intermediate portion435 of electrode 430. In various embodiments, the shaft of the surgicalinstrument, such as shaft 104 of surgical instrument 100, for example,can comprise one or more passages or conduits therein which can be influid communication with the passages 439, for example, such that theheated vapors can be conveyed away from the end effector and out of thepatient. In at least one such embodiment, the handle of the surgicalinstrument, such as handle 102, for example, can comprise at least onevent configured to allow the heated vapors to vent into the atmospheresurrounding the patient, for example.

In various embodiments, referring now to FIG. 38B, a jaw 434′ of an endeffector 406′ can comprise, similar to the above, a supply electrode 430having first and second portions 431, 433 and steam control pathscomprising passages 437, 439 extending therethrough. The end effector406′ can further comprise at least one return electrode 436 and one ormore electrically non-conductive insulators 438 positioned intermediateportions of the supply electrode 430 and portions of the returnelectrode 436. In various embodiments, the return electrode and/or theinsulators can comprise one or more steam control paths for conveyingsteam away from the tissue being treated. For example, the returnelectrode can comprise one or more channels 432 therein which can beconfigured to convey the steam in a space intermediate the tissue and anoutside surface of the return electrode 436. Also, for example, theinsulators 438 can comprise one or more passages 439′ extendingtherethrough. Although passages 437, 439, and 439′ are illustrated ascomprising round, or at least substantially round, elongateconfigurations, the passages extending through the supply electrode, thereturn electrode, and/or the insulators can comprise any suitableconfiguration, such as square and/or rectangular configurations, forexample. Furthermore, although channels 432 are illustrated as havingsubstantially orthogonal sidewalls, the sidewalls of the channels cancomprise any suitable configuration, such as arcuate and/orsemi-circular configurations, for example. In any event, any one of thesupply electrode, return electrode, and/or insulators can comprise anysuitable number of exterior channels and/or internal passages thereinfor conveying heated vapors away from the tissue in the end effector. Incertain embodiments, referring again to FIG. 38B, a cutting member 440can comprise one or more steam paths 439″ extending therethrough.

As described above, electrical energy, or current, can be supplied tothe electrodes of an end effector, such as electrode 130 of end effector106, for example, in order to treat, heat, and/or seal tissue capturedwithin the end effector 106. As also described above, the tissue can betransected by a knife or cutting member. In various circumstances,however, it may not be desirable to transect the tissue prior tosupplying electrode 130 with current and/or prior to the application ofheat to the tissue. In various embodiments described herein, surgicalinstrument 100, for example, can comprise a trigger system, such astrigger system 120, for example, which can be configured to prevent thecutting member 140 (FIG. 3) of surgical instrument 100 from beingadvanced toward the distal end 107 of end effector 106 prior to theelectrical current being supplied to electrode 130. In certainembodiments, the cutting member 140 can be advanced at the same timethat current is supplied to electrode 130. In certain other embodiments,the current can be supplied to electrode 130 prior to cutting member 140being advanced to transect the tissue.

In various embodiments, referring now to FIGS. 31-36, the trigger system120 can comprise an energy actuation button 122 mounted to a first link124, a second link 126 operably coupled with first link 124, and apivotable lock 150 which can be moved between a locked position and anunlocked position by second link 126. The button 122 can be moveablebetween an unactuated, or undepressed, position (FIG. 32) and anactuated, or depressed, position (FIG. 33) in order to electricallyconnect, or couple, a first portion 114 a of supply wire 114 and asecond portion 114 b of supply wire 114. More particularly, the triggersystem 120 can further comprise a switch 123 mounted to first link 124which can be switched, or closed, when button 122 is depressed such thatcurrent can flow from the electrical input 110, through the first supplywire portion 114 a, and into the second supply wire portion 114 b andslip ring 116. As described above, the current can then flow toelectrode 130, through return wire 117, and then through the electricaloutlet in order to complete the electrical circuit. In variousembodiments, the switch 123 can comprise a spring, such as a linear coilspring, for example, positioned therein which can be compressed when thebutton 122 is moved from its unactuated position to its actuatedposition. In at least one such embodiment, the coil spring can bepositioned intermediate the button 122 and a housing of the switch 123and/or first link 124. In any event, in certain embodiments, a force isrequired to compress the spring and, in addition, the button 122 isrequired to move a predetermined distance in order to actuate switch123.

In various embodiments, further to the above, the force applied tobutton 122 in order to actuate switch 123 can cause first link 124 tomove. More particularly, the force applied to button 122 can betransmitted through the coil spring to switch 123 wherein the force canthen be transferred to first link 124. In at least one embodiment,referring again to FIG. 32, the first link 124 can comprise a first end125 pivotably mounted to handle body 112 via a pivot or pin 118extending from handle body 112 and through an aperture in first end 125.When first link 124 is moved by the force, the first link 124 can rotateor pivot about an axis defined by pin 118 in a direction indicated byarrow A (FIG. 32). In various embodiments, the first link 124 canfurther comprise a drive member 127 extending therefrom which can beconfigured to move second link 126. In at least one embodiment, thesecond link 126 can comprise a first end 129 pivotably mounted to handlebody 112 via a pivot or pin 119 extending from handle body 112 andthrough an aperture in first end 129. The drive member 127 can extendinto a slot 128 in second link 126 such that, when the first link 124 isrotated about pivot 118 in direction A, the second link 126 can berotated about pivot 119 in a direction indicated by arrow B (FIG. 32).More particularly, the drive member 127 extending into slot 128 canengage a sidewall of the slot 128 so as to transmit movement betweenfirst link 124 and second link 126. In various embodiments, further tothe above, the second link 126 can further comprise a second end 151which can be configured to engage rack 150 and rotate rack lock 150between an unactuated, locked position (FIG. 33) and an actuated,unlocked position (FIG. 34). More particularly, when second link 126 isrotated in direction B, the rack lock 150 can be rotated in a directionindicated by arrow C (FIG. 32) about an axis defined by pivot 152 onyoke 154. When rack lock 150 is sufficiently rotated in direction C, asdescribed in greater detail further below, tooth 155 extending from racklock 150 may be sufficiently removed from notch 162 a in rack 160 suchthat rack 160 can be moved relative to lock 150.

As described above, the force applied to button 122 in order to actuateswitch 123 can rotate first link 124 about pivot 118, rotate second link126 about pivot 119, and rotate rack lock 150 between locked andunlocked positions. In at least one embodiment, such a force can besufficient to actuate switch 123 and unlock rack 150 at the same time,or at least substantially the same time. In such embodiments, energy canbe supplied to the electrode 130 at the same time that rack 160 becomesunlocked and capable of advancing knife bar 140 distally within endeffector 106 as described in greater detail below. In variouscircumstances, as a result, the trigger system 120 can assure that thetissue positioned within the end effector is not transected before it isat least partially treated and/or sealed. In various other embodiments,referring again to FIG. 32, the trigger system 120 can further comprisea trigger spring 121 operably engaged with the first link 124, forexample, which can be configured to resist the movement of first link124 in the direction indicated by arrow A. In at least one embodiment,the force applied to button 122 to actuate switch 123 may beinsufficient to rotate first link 124 and second link 126 a sufficientdistance to move rack lock 150 into its unlocked position. In suchembodiments, the switch 123 can be actuated to supply electrode 130 withcurrent while the rack 160 can remain locked in place by rack lock 150.More particularly, further to the above, the tooth 155 of rack lock 150can remain biased into first notch 162 a by lock spring 156 such thatrack 160 is prevented from moving, or at least substantially moving,relative to rack lock 150. In various other embodiments, further to theabove, a rack lock may be slid between a first position in which it islocked with a rack, such as rack 160, for example, and a second positionin which it is unlocked from the rack. In at least one such embodiment,the rack lock can be moved along a straight line.

In order to overcome the biasing force of trigger spring 121, further tothe above, a larger, or second, force may need to be applied to button122 and/or first link 124. More particularly, in the event that theforce, or first force, used to depress button 122 and actuate switch 123is insufficient to unlock rack lock 150, a second, or larger, force canbe applied to button 122, for example, in order to sufficiently compressspring 121, sufficiently rotate first link 124 and second link 126, androtate rack lock 150 into an unlocked position. In such circumstances, aclinician may apply a light force to button 122 in order to actuate theelectrical energy system and a heavier force to button 122 in order tounlock the rack 160. In various embodiments, referring to FIG. 1,trigger spring 121 can be positioned intermediate first link 124 andhandle body 112 such that trigger spring 121 is compressed as first link124 is rotated in the direction indicated by arrow A. The length and/orstiffness of trigger spring 121 can be selected such that the coilspring within switch 123 is sufficiently compressed to supply electrode130 with electrical energy before the trigger spring 121 is sufficientlycompressed to unlock rack 160. In such embodiments, as a result, thetreatment or sealing of the tissue positioned within the end effector106, for example, can begin before rack 160 and cutting member 140 canbe advanced. In certain circumstances, the difference between the firstforce and the second force can be large enough such that a surgeon, orother clinician, using the surgical instrument 100 may be provided witha tactile feedback as to whether the surgical instrument is in a firstoperating condition in which energy is being applied to the tissue andthe cutting member is not being advanced within the end effector and asecond operating condition in which energy is being applied to thetissue and the cutting member is being advanced within the end effectorto transect the tissue. For example, the switch spring and the triggerspring 121 can be selected such that a significantly smaller force isrequired to depress button 122 and actuate switch 123 as compared to asignificantly larger force required to unlock rack lock 150. In thevarious alternative embodiments where it may be desirable for theelectrical energy to be supplied to electrode 130 at the same time, orat least substantially the same time, that the rack 160 becomesunlocked, the stiffness of the spring in switch 123 and the stiffness oftrigger spring 121 can be selected such that a force which is sufficientto actuate button 122 can also be sufficient to rotate lock 150 into anunlocked configuration. In at least one such embodiment, the forcenecessary to actuate button 122 can be the same, or at leastsubstantially the same, as the force necessary to unlock rack 160.

In various circumstances, the surgeon can release button 122 such thatthe spring of switch 123 can return button 122 to an unactuated positionand operably disconnect first portion 114 a and second portion 114 b ofsupply wire 114. In such circumstances, electrical current may no longerflow to electrode 130 and, as a result, the electrode 130 and the tissuewithin the end effector may begin to cool. In addition to the above, thetrigger spring 121 may return first link 124 and/or second link 126 totheir unactuated positions and the lock spring 156 may return rack lock150 to an unlocked position. More particularly, referring now to FIG.36, in the event that the button 122 is released and the rack 160 hasnot been advanced, or has been returned to its starting position, thelock spring 156 can reposition the lock tooth 155 within the notch 162 aand relock the rack 160 in position. In various other circumstances, therack 160 may be sufficiently advanced such that the rack tooth 155cannot be reseated within the notch 162 a and, as a result, the lockspring 156 may position the tooth 155 against a top surface 161 of rack160 in an unlocked position. In such circumstances, the rack 160 and thecutting member 140 can be advanced within the tissue without currentflowing to the electrode 130. In various other embodiments, referringnow to FIG. 35, a rack 160′ can comprise a plurality of notches 162a-162 e, for example, which can, once the button 122 has been released,allow the lock spring 156 to return the lock 150 to a lockedconfiguration even though the rack 160′ and the cutting member 140 havealready been advanced. More particularly, depending on the distance thatrack 160 has been advanced, the lock spring 156 can position the locktooth 155 in any one of the notches 162 b-162 e, for example. In orderto prevent the lock 150 from re-engaging with the rack 160′ as it isbeing advanced, in at least one such embodiment, the surgeon may keepthe button 122 depressed and the first link 124 and the second link 126sufficiently rotated in order to keep the lock 150 in an unlockedposition. In such circumstances, owing to the constant depression ofbutton 122, electrical energy can be supplied to the electrode 130during the entire, or at least substantially entire, advancement of rack160 and cutting member 140.

As discussed above, lock spring 156 can be configured to bias lock 150into engagement with rack 160. In various embodiments, referring now toFIG. 34A, lock spring 156 can comprise a torsion spring including a coil156 a positioned about pivot pin 152, a first end extending from coil156 a mounted to yoke 154, and a second end 156 b. In at least oneembodiment, the second end 156 b can comprise a torque arm which, whenthe lock 150 is rotated about pivot pin 152 as described above, thesecond end 156 b can torque or compress the spring coil 156 a. In suchcircumstances, the spring 156 can store potential energy therein which,when released, can act to move lock 150 from its unlocked position intoits locked position. In various embodiments, the second end 156 b cancomprise a hook or attachment portion 156 c which can mount the secondend 156 b to lock 150 such that the second end 156 b moves the lock 150.

In various embodiments, referring again to FIGS. 32-34, the distance tomove button 122 from an unactuated position to an actuated position canbe shorter than the distance to rotate link 124 sufficiently to movelock 150 between a locked position and an unlocked position. Statedanother way, in various embodiments, the actuation of button 122,although it may cause first link 124 and second link 126 to rotate, maybe insufficient to rotate first link 124 and second link 126 asufficient distance to move lock 150 into its unlocked configuration. Inat least one such embodiment, as a result, the button 122 can bedepressed to supply electrical energy to the electrode 130 while therack 160, for example, can remain locked in position by rack lock 150.In such circumstances, the tissue can be sealed, or at least partiallysealed, before the cutting member 140 is advanced through the tissuewithin the end effector 106. In various circumstances, the button 122and the first link 124 can be moved an additional distance in order tosufficiently rotate lock 150 into an unlocked configuration such thatrack 160 and cutting member 140 can be advanced into and/or through thetissue. Stated another way, in various embodiments, the button 122 canbe moved a first distance to supply electrical current to electrode 130although the button 122 can be moved a total distance which is greaterthan the first distance to unlock rack lock 150. In various embodiments,the difference between the first distance and the total distance thatbutton 122 is moved can be sufficient to provide a sufficiently largewindow of operation to allow the surgeon to move button 122 within arange of distances while not unlocking the rack lock 150. In the variousalternative embodiments where it may desired to supply electrical energyto electrode 130 at the same time, or at least substantially the sametime, that rack 160 becomes unlocked, the distance necessary to actuatebutton 122 may the same, or at least substantially the same, as thedistance necessary to move lock 150 between its locked and unlockedconfigurations.

Once rack lock 150 has been disengaged from rack 160, as describedabove, rack 160 and cutting member 140 can be advanced toward distal end107 (FIG. 3) of end effector 106. In various embodiments, as describedin greater detail below, the advancement of cutting member 140 can, one,move jaw 108 toward jaw 109 and, two, incise the tissue captured betweenjaw 108 and jaw 109. Referring to FIG. 1, the handle 102 can furthercomprise a trigger 170 which can be moved between an unactuatedposition, as illustrated in FIG. 1, and an actuated position, asillustrated in FIG. 18. The movement of trigger 170 between its actuatedposition and unactuated position can define one stroke of trigger 170,although such a stroke can comprise two different ranges of motion. Moreparticularly, in at least one embodiment, the stroke can comprise afirst range of motion which drives a first drive system and a secondrange of motion which drives a second drive system. In variousembodiments, the trigger 170, in co-operation with the first drivesystem, can advance the rack 160 and the cutting member 140 between afirst position (FIG. 3) and a second position (FIG. 7) during the firstrange of motion of trigger 170, wherein the trigger 170, in co-operationwith the second drive system, can advance the rack 160 and the cuttingmember 140 between a second position (FIG. 7) and a third position (FIG.19) during the second range of motion of trigger 170. When the cuttingmember 140 is moved between its first position (FIG. 3) and its secondposition (FIG. 7), as described in greater detail below, the cuttingmember 140 can move the second jaw 108 toward the first jaw 109 andclamp tissue positioned therebetween. When the cutting member 140 ismoved between its second position (FIG. 7) and its third position (FIG.19), as described in greater detail further below, the cutting member140 can be advanced toward the distal end 107 to incise the tissueclamped between jaw 108 and jaw 109.

In various embodiments, referring now to FIG. 2, the first drive systemcan comprise a toggle clamp 180 which can be moved between a firstconfiguration (FIG. 2) associated with the first position (FIG. 3) ofcutting member 140 and a second configuration (FIG. 6) associated withthe second position (FIG. 7) of cutting member 140. The toggle clamp180, referring again to FIG. 2, can comprise a first link 182 and asecond link 184. The first link 182 can comprise a first end pivotablymounted to handle body 112 at first pivot 181, via a pivot pin, forexample, and, in addition, the second link 184 can comprise a first endpivotably mounted to yoke 154 at a second pivot 183, also via a pivotpin, for example. Further to the above, the first link 182 and thesecond link 184 can each comprise second ends which are pivotablymounted to each other via an intermediate pivot pin 185, for example. Incertain embodiments, the intermediate pivot pin 185 can comprise avertex of an angle defined between a first line, or axis, 186 extendingthrough the centers of first pivot 181 and intermediate pivot 185 and asecond line, or axis, 187 extending through the centers of second pivot183 and intermediate pivot 185. In various embodiments, the first line186 and the second line 187 can define a vertex angle α therebetween.Opposite vertex angle α is a line, or axis, 188 defined between thecenter of first pivot 181 and the center of second pivot 183. Whentoggle clamp 180 is in its first configuration, in various embodiments,the vertex angle α can be about 90 degrees and/or slightly greater than90 degrees, for example. In at least one embodiment, angle α can beabout 120 degrees when toggle clamp 180 is in its first configuration,for example. Although such angles may be suitable in variouscircumstances, any other suitable angle can be used.

In various embodiments, further to the above, the trigger 170 can bemoved from its unactuated position (FIG. 2) into a partially actuatedposition (FIG. 4) as part of its first range of motion. As the readerwill see when comparing FIG. 2 and FIG. 4, trigger 170 is pivotablymounted to handle body 112 via a pivot 171, such as a pivot pin, forexample. When trigger 170 is rotated about pivot 171, trigger 170 canbegin to move the toggle clamp 180 from its first configuration (FIG. 2)into its second configuration (FIG. 6). More particularly, in at leastone embodiment, the trigger 170 can further comprise a cam, or driver,172 extending therefrom which can be configured to engage first link 182and lift the second end of link 182 upwardly and, at the same time,rotate first link 182 about first pivot 181 in a direction indicated byarrow D (FIG. 4). Owing to the pivoted connection of the second ends offirst link 182 and second link 184, the upward movement of the secondend of first link 182 can cause the second end of second link 184 tomove upwardly and, at the same time, rotate about second pivot 183 in adirection indicated by arrow E (FIG. 4). In various embodiments, thefirst link 182 can comprise a cam, or drive, pocket 173 which can beengaged by cam, or driver, 172 in order to transmit the rotation oftrigger 170 to first link 182. In order to accommodate the upwardmovement of the second ends of links 182 and 184 and the upward movementof intermediate pivot 185, the yoke 154 can translate distally in adirection indicated by arrow F (FIG. 4).

In various embodiments, referring again to FIG. 4, the distal movementof yoke 154 in the direction F can be transmitted to rack 160 andcutting member 140 such that rack 160 and cutting member 140 are alsomoved in direction F. More particularly, further to the above, the racklock 150 mounted to yoke 154, when engaged with rack 160, can allow theyoke 154 to pull the rack 160 distally when the yoke 154 is pusheddistally by toggle clamp 180 as described above. Furthermore, owing tothe connection between rack 160 and cutting member 140, the distalmovement of rack 160 can be transmitted to cutting member 140. Moreparticularly, in at least one embodiment, the cutting member 140 cancomprise a proximal portion 142 which can be connected to the distal end165 of rack 160. In various embodiments, such a connection can prevent,or at least inhibit, relative longitudinal movement between cuttingmember proximal end 142 and rack distal end 165 while permittingrelative rotational movement therebetween owing to a round head 143 ofthe proximal end 142 captured within a round cavity in the distal end165 of rack 160. In any event, referring now to FIG. 5, the proximalmovement of cutting member 140 can, in at least one embodiment, causecutting member 140 to engage the second jaw 108 and move, or rotate,second jaw 108 toward first jaw 109. More particularly, the cuttingmember 140 can comprise one or more cams, or cam pins, 144 a which canbe configured to engage one or more cam surfaces 145 on second jaw 108and rotate second jaw 108 downwardly about one or more pivot pins 103,for example.

In various embodiments, further to the above, the rotation of trigger170 through its first range of motion can move the toggle clamp 180between its first, or unactuated, configuration (FIG. 2) and its second,or fully actuated, configuration (FIG. 6). Also further to the above,the movement of the toggle clamp 180 between its first configuration andits second configuration can move the cutting member 140 between itsfirst position (FIG. 3) and its second position (FIG. 7) and, as aresult, move second jaw 108 between its fully open position (FIG. 3) andits fully closed position (FIG. 7). When comparing the toggle clamp 180in its second configuration as compared to its first configuration, thereader will note that the vertex angle α defined between first line 186and second line 187 is about 180 degrees, for example. In at least oneembodiment, the vertex angle α can be about 175 degrees, for example.Furthermore, the reader will note that the second pivot 183 has moveddistally respect to first pivot 181 as yoke 154 has been moved distallyas described above. As a result of the above, the toggle clamp 180 cantransmit a very large longitudinal force to rack 160 and cutting member140 in the distal direction F. In fact, this very large longitudinalforce can increase exponentially and/or asymptotically as the vertexangle α approaches approximately 180 degrees. This very largelongitudinal force can apply a large biasing force to second jaw 108such that a large clamping force, or pressure, is applied to the tissuepositioned intermediate the first jaw 109 and the second jaw 108.

In various embodiments, referring now to FIG. 8, the distal movement ofyoke 154 can compress a yoke spring, such as axial spring 147, forexample, intermediate yoke 154 and a spine 105 of shaft 104. In at leastone embodiment, as described in greater detail below, the axial spring147 can store potential energy therein which can be released in order toat least partially retract rack 160 and cutting member 140. Although thetoggle clamp 180 is illustrated in its first, or unactuatedconfiguration, in FIG. 8, the axial spring 147 is at least partiallycompressed between shaft spine 105 and yoke 154. In variouscircumstances, the compression force applied to shaft spine 105 and yoke154 by spring 147 can provide an additional benefit of inhibitingrelative movement between shaft spine 105 and yoke 154.

In various embodiments, referring now to FIG. 9 which illustrates thetoggle clamp 180 in its first configuration and the trigger assembly 120in its unactuated configuration, the rack lock 150 is in its lockedposition and rack 160 is in its unadvanced position. In such aconfiguration, further to the above and referring now to FIG. 10, thetrigger assembly 120 can be actuated so as to rotate first link 124about pivot 118 and rotate second link 126 about pivot 119; however, incircumstances where the rack 160 and cutting member have not yet beenadvanced into their second positions, for example, the actuation oftrigger assembly 120 may not move rack lock 150 into its unlockedposition. Upon the advancement of rack 160 and cutting member 140 intotheir second positions, referring now to FIG. 11, the rack lock 150 canbe moved into contact with second link 126 such that rack lock 150 isrotated from its locked position to its unlocked position.Alternatively, referring now to FIG. 12, the rack 160 and cutting member140 can be advanced from their first positions (FIG. 9) to their secondpositions (FIG. 12) when the toggle clamp 180 is moved from its firstconfiguration into its second configuration, as described above, andwherein, upon a sufficient actuation of trigger assembly 120, asdescribed above, the second link 126 can contact rack lock 150 androtate rack lock 150 into its unlocked configuration as illustrated inFIG. 13. In any event, upon the completion of its first range of motion,trigger 170 can, as described in greater detail below, become operablydisengaged from the first drive system and/or operably engaged with thesecond drive system.

Referring now to FIG. 15 which depicts the trigger 170 at the end of itsfirst range of motion, the reader will see that the cam 172 is no longerpositioned within pocket 173 in first link 182. As a result, the cam 172may no longer drive the toggle clamp 180 despite any further rotation oftrigger 170 toward its actuated position (FIG. 18), and, as a result,the trigger 170 may be operably disconnected from the first drivesystem. The reader will also see that, at this position of trigger 170,the trigger 170 has been moved into operative engagement with triggergear 175 and the second drive system. More particularly, referring nowto FIG. 16, the trigger 170 can further comprise a drive pin 176extending therefrom which is configured to contact the bottom surface177 of trigger gear 175 and, once engaged with trigger gear 175, push,or rotate, the trigger gear 175 upwardly such that the trigger gear 175rotates a compounding gear 191 of the rack and pinion system 190 astrigger 170 is moved through its second range of motion. As the readerwill note, the trigger gear 175 comprises an array of teeth 178 whichare operably engaged with, or meshed with, the compounding gear 191while the trigger 170 is moved through its first range of motion,although, the teeth 178 do not drive the compounding gear 191 during thefirst range of motion of trigger 170. On the other hand, the rotation oftrigger 170 in its second range of motion can cause trigger gear 175 todrive or rotate compounding gear 191 as described in greater detailfurther below. In various embodiments, further to the above, thedisengagement of cam 172 from pocket 173 in first link 182 can occur atthe same time, or at least substantially the same time, as the trigger170 comes into operative engagement with trigger gear 175.Alternatively, the trigger 170 may not come into operative engagementwith trigger gear 175 until after the cam 172 has been disengaged frompocket 173. In at least one such embodiment, the rotation of trigger 170may comprise a dwell period in which the trigger 170 is not operativelyengaged with either the first drive system of the second drive system.

Once trigger 170 has been operatively engaged with trigger gear 175,further to the above, the further rotation of trigger 170 can, one,cause the cam 172 to move relative to a bottom surface 187 of first link182, and, two, rotate compounding gear 191. In at least one embodiment,the compounding gear 191 can be mounted to a pin 192 which can berotatably mounted between the two halves of handle body 112. Referringagain to FIG. 16, the rack and pinion system 190 can further comprise anadditional, or second, compounding gear 193 which can be mounted to pin192. In at least one such embodiment, the compounding gears 191, 193 canbe mounted to pin 192 such that the rotation of one of compounding gears191, 193 causes the rotation of the other of the compounding gears 191,193. In various embodiments, the rack and pinion system 190 can furthercomprise a third compounding gear 195 which can be mounted to a pin 194which can be rotatably mounted between the two halves of handle body112. As illustrated in FIG. 16, the third compounding gear 195 can beoperably meshed with the second compounding gear 193 such that therotation of second compounding gear 193 can rotate the third compoundinggear 195. The rack and pinion system 190 can further comprise a piniongear 197 which can also be mounted to pin 194, wherein, similar to theabove, the compounding gear 195 and the pinion gear 197 can be mountedto pin 194 such that the rotation of one of gears 195, 197 causes therotation of the other of the gears 195, 197. As also illustrated in FIG.16, the pinion gear 197 is operably or meshingly engaged with the rackteeth 164 on rack 160 such that the rotation of pinion gear 197 canmove, or displace, rack 160 along a straight, or at least substantiallystraight, path, for example.

During the second range of motion of trigger 170, further to the above,the rotation of trigger 170 can be transmitted to pinion gear 197 viacompounding gears 191, 193, and 195 such that, owing to the gear ratioof gears 191, 193, 195, and 197, a small rotation of trigger 170 canresult in a large displacement of rack 160 and cutting member 140. Invarious embodiments, as described above, the rotation of trigger 170through its second range of motion can move cutting member 140 betweenits second position (FIG. 17) and its third position (FIG. 19). In itssecond position, referring to FIG. 17, the cutting member 140 can bepositioned within the end effector 106 such that the knife edge 146 ofcutting member 140 is positioned to be advanced through the tissuecaptured between first jaw 109 and second jaw 108, and owing to therotation of trigger 170, trigger gear 175, and gears 191, 193, 195, and197, the rack 160 can be displaced in the distal direction F so as todisplace the cutting member 140 toward the distal end 107 of endeffector 106. In its third position, referring to FIGS. 18 and 19, thecutting member 140 can be positioned at the distal end 107 of endeffector 106. In at least one embodiment, referring to FIG. 20, jaw 108and/or jaw 109 can comprise a slot 149 which can be configured toreceive at least a portion of cutting member 140 and guide cuttingmember 140 toward the distal end 107. In certain embodiments, the campins 144 a extending from cutting member 140 can be configured to rideon top of cam surface 148 a on the outside of jaw 108 such that jaw 108is compressed toward jaw 109. Similarly, cutting member 140 can furthercomprise cam pins 144 b extending therefrom which can be configured toride on cam surface 148 b on the outside of jaw 109 such that jaw 109 iscompressed toward jaw 108. Stated another way, the cam pins 144 a and144 b can engage the cam surfaces 148 a and 148 b, respectively, inorder to apply a clamping force or pressure to the tissue positionedintermediate jaw 108 and jaw 109. In certain embodiments, referringagain to FIG. 20, jaw 108 and/or jaw 109 can further comprise a stop 147which can be configured to stop the distal displacement of cuttingmember 140 through the tissue. In at least one embodiment, the stop 147can be positioned proximally with respect to the distal end of electrode130 such that the knife edge 146 may not transect tissue which has notbeen sealed.

Once the trigger 170 has been moved through its second range of motionand/or at any suitable moment during the second range of motion, thetrigger 170 can be released. Upon the release of trigger 170, a returnspring, such as torsion spring 199 (FIG. 28), for example, can reversethe rotation of compounding gears 191, 193, and 195 and pinion gear 197in order to retract rack 160 and cutting member 140 in a proximaldirection, i.e., in a direction opposite direction F. In at least oneembodiment, referring to FIG. 28, one end of the torsion spring 199 canbe engaged with the compounding gear 191 and another end of the torsionspring 199 can be engaged with the handle body 112, for example, suchthat potential energy stored within the torsion spring 199 when the rack160 is advanced can be released when the trigger 170 is released inorder to rotate compounding gear 191 in a reverse direction. In additionto the above, referring to FIG. 21 the reverse rotation of compoundinggear 191 can, owing to the meshing engagement of trigger gear teeth 178and compounding gear 191, rotate trigger gear 175 downwardly in adirection indicated by arrow G. In various embodiments, the downwardrotation of trigger gear 175 can be transmitted to trigger 170 via theinteraction of drive surface 177 acting against the drive pin 176 inorder to retract, or return, the trigger 170 through its second range ofmotion, as illustrated in FIG. 22. In at least one embodiment, thesurgical instrument can further comprise a reversing plate 200 which canbe operably engaged with compounding gear 191 such that the reverserotation of compounding gear 191 can also be transmitted to trigger gear175 via reversing plate 200. The reversing plate 200 can be keyed tocompounding gear 191 and/or pin 192 such that, as compounding gear 191is driven in a reverse direction by return spring 199, the reversingplate 200 is driven downwardly and rotated about an axis defined by pin192 in a direction indicated by arrow H. In such circumstances,referring to FIG. 22, the reversing plate 200 can act against drive pin202 extending from trigger gear 175 to drive trigger gear 175downwardly.

In various embodiments, further to the above, the return spring 199, viagears 191, 193, 195, and 197, can return the cutting member 140 and therack 160 from their third position to their second position and allowthe rack lock 150 to re-engage the rack 160 as illustrated in FIG. 23.Owing to the re-engagement of rack lock 150 with rack 160, the yokespring 147 can push yoke 154, rack 160, and cutting member 140 in aproximal direction, i.e., a direction opposite direction F. In variouscircumstances, the yoke spring 147, via yoke 154, can move the rack 160and the cutting member 140 from their second positions to their firstpositions. In addition to the above, when yoke spring 147 pushes yoke154 backward, the yoke 154 can drive, or collapse, the toggle clamp 180between its second configuration (FIG. 22) into its first configuration(FIG. 23). In such circumstances, referring to FIGS. 23 and 24, the cam172 extending from trigger 170 can become re-engaged with the pocket 173in first link 182 such that the first link 182 can drive the trigger 170through its first range of motion into its unactuated position asillustrated in FIG. 26.

When the cutting member 140 is returned to its first position from itssecond position, as described above and referring to FIGS. 25 and 27,the cutting member 140 can move second jaw 109 from its closed positionto its open position. More particularly, in at least one embodiment, thecutting member 140 can further comprise at least one opening cam pin 141extending therefrom which, when moved proximally, can engage cam surface101 a on second jaw 109 such that second jaw 109 is pivoted upwardlyabout pivot pins 103 into its open position as illustrated in FIG. 27.Once jaw 109 has been moved into its open position, the cam pin 141 canbe further retracted such that it is positioned over and/or against locksurface 101 b which is positioned proximally with respect to cam surface101 a. In such circumstances, the second jaw 109 can be locked or heldin an open position by cam pin 141. In any event, in order to assurethat the cutting member 140 has been fully returned to its firstposition, the drive pin 176 extending from trigger 170 can engage thesidewall of a slot 204 in reversing plate 200 as trigger 170 is returnedto its unactuated position. More particularly, the drive pin 176 canassure that the reversing plate 200, the compounding gears 191, 193,195, and 197, and the rack 160 have been returned to their initialpositions and, as a result, assure that cutting member 140 has beenreturned to its initial position.

As described above, the trigger 170 comprises a drive pin 176 which, atthe end of the first range of motion of trigger 170, can contact thedrive surface 177 of trigger gear 175 in order to move trigger gear 175upwardly. In such circumstances, the trigger 170 and trigger gear 175move together about a common axis of rotation defined by pivot 171. Whentrigger 170 is released and returned to its unactuated position,however, the trigger 170 and trigger gear 175 can, referring to FIGS.21-24, for example, move independently of one another and rotaterelative to one another. More particularly, the trigger 170 and triggergear 175 can move relative to one another about a pivot 179 on trigger170 as trigger 170 is returned to its unactuated position and as thesurgical instrument 100 is reset to its initial configuration.

In various embodiments, referring now to FIG. 41, an alternativesurgical instrument can comprise substantially the same components andsystems as surgical instrument 100, although the alternative surgicalinstrument can comprise a trigger assembly 170′ comprising a firstportion 170 a′ and a second portion 170 b′. In certain embodiments,relative movement between the first portion 170 a′ and the secondportion 170 b′ is possible during the actuation of trigger 170′. Moreparticularly, in at least one embodiment, a force overload mechanism canbe positioned intermediate the first trigger portion 170 a′ and thesecond trigger portion 170 b′ such that, when the force applied totrigger portion 170 a′ exceeds a predetermined value, the triggerportion 170 a′ can move relative to the trigger portion 170 b′ andprevent any force in excess of the predetermined value from beingtransmitted to trigger gear 175 via drive pin 176′. Referring now toFIG. 42, the first trigger portion 170 a′ can comprise a pivot hole 171a′ which can be aligned with, referring to FIG. 43, a pivot hole 171 b′in second trigger portion 170 b′ wherein, when the first portion 170 a′and the second portion 170 b′ are assembled together, as illustrated inFIG. 41, the first portion 170 a′ and the second portion 170 b′ canrotate together about an axis defined by pivot 171′. More particularly,a force, or load, FA applied to first portion 170 a′ can cause firstportion 170 a′ to rotate about pivot 171′ and, owing to drive pin 176′,the rotation of first portion 170 a′ can be transmitted to secondportion 170 b′ in order to cause second portion 170 b′ to be rotatedabout pivot 171′. In at least one embodiment, the drive pin 176′ can beslidably positioned within a slot 212′ within first portion 170 a′,wherein the first portion 170 a′ can further comprise a spring, such asan axial compression 216′, for example, configured to bias the drive pin176′ against the end 214′ of slot 212′. As illustrated in FIG. 41, thedrive pin 176′ can extend through a drive aperture 218′ in secondportion 170 b′, wherein, in various circumstances, at least a portion ofthe force FA applied to first trigger portion 170 a′ can be transmittedthrough the spring 216′, drive pin 176′, and a sidewall of driveaperture 218′ in order to apply a force to second trigger portion 170b′.

In various embodiments, further to the above, the force transmittedbetween the first trigger portion 170 a′ and the second trigger portion170 b′ can be represented by a force FT (FIG. 41) which is transmittedthrough spring 216. As illustrated in FIG. 41, the force FT can bealigned, or collinear, with the longitudinal, or axial, axis of spring216′. When the force FT is at or below the predetermined, or threshold,value described above, the first portion 170 a′ and the second portion170 b′ can move together with little, if any, relative movementtherebetween. In at least one such embodiment, the spring 216′ can becompressed between the drive pin 176′ and a second sidewall 215′ of theslot 212 such that the spring 216′ is compressed by a preload forcewhich is equal to, or at least substantially equal to, the predeterminedthreshold value. In such circumstances, the spring 216′ may not befurther compressed unless and if the force FT exceeds the predeterminedthreshold value. Once the force FT exceeds the predetermined thresholdvalue, the spring 216′ may be further compressed, thereby permittingrelative movement between first portion 170 a′ and second portion 170b′. Furthermore, owing to such relative movement, the force in excess ofthe predetermined threshold value may be absorbed by the spring 216′instead of being transmitted to trigger gear 175 via drive pin 176′.Such embodiments can prevent an excessive force from being applied torack 160 and cutting member 140 and, as a result, an overload conditioncan be avoided, or at least partially ameliorated.

In various embodiments, referring now to FIG. 44, an alternativesurgical instrument can comprise substantially the same components andsystems as surgical instrument 100, although the alternative surgicalinstrument can comprise a trigger assembly 170″′ comprising a firstportion 170 a″′ and a second portion 170 b″′. In certain embodiments,relative movement between the first portion 170 a″′ and the secondportion 170 b″′ is possible during the actuation of trigger 170″′.Similar to the above, in at least one embodiment, a force overloadmechanism can be positioned intermediate the first trigger portion 170a″′ and the second trigger portion 170 b″′ such that, when the forceapplied to trigger portion 170 a″′ exceeds a predetermined value, thetrigger portion 170 a″′ can move relative to the trigger portion 170 b″′and prevent any force in excess of the predetermined value from beingtransmitted to trigger gear 175 via drive pin 176″′. Similar to theabove, the first trigger portion 170 a″′ and the second trigger portion170 b″′ can be pivotable about pivot pin 171″′, wherein a force, orload, FA applied to first portion 170 a″ can cause first portion 170 a″to rotate about pivot 171″′ and, owing to beam, or link, 216″′, therotation of first portion 170 a″′ can be transmitted to second portion170 b″′ in order to cause second portion 170 b″′ to be rotated aboutpivot 171″′. More particularly, in at least one embodiment, a first end217″ of beam 216″′ can be fixedly mounted to first trigger portion 170a″′ and a second end 218″′ of bean 216″′ can be fixedly mounted tosecond trigger portion 170 b″′, wherein, in various circumstances, atleast a portion of the force FA applied to first trigger portion 170 a″′can be transmitted through the beam 216″′ in order to apply a force tosecond trigger portion 170 b″′.

In various embodiments, when the force transmitted through beam 216″ isat or below a predetermined, or threshold, value, the first portion 170a″ and the second portion 170 b″ can move together with little, if any,relative movement therebetween. More particularly, the beam 216″ can beconfigured such that, although the below-threshold force transmittedthrough beam 216″ may create a compressive contraction or other minorelastic deformation within the beam 216″, the beam 216″ will remainlargely undeflected as long as the force transmitted therethrough isbelow the threshold value. Once the force transmitted through beam 216″exceeds the predetermined threshold value, however, the beam 216′ maybuckle, thereby permitting relative movement between first portion 170a′ and second portion 170 b′. Such relative movement is depicted in FIG.44 which illustrates the first portion 170 a″ in phantom lines as havingmoved relative to second trigger portion 170 b″. In such circumstances,the first end 217″ can move toward the second end 218″ such that beam216 buckles or collapses laterally. In various circumstances, suchbuckling can be elastic or resilient which could allow the first triggerportion 170 a″ to be reset relative to the second trigger portion 170b″. In other circumstances, the buckling can be at least partiallyinelastic, or plastic, which may prevent or inhibit such a reset. In anyevent, the various embodiments described above can prevent an excessiveforce from being applied to rack 160 and cutting member 140 and, as aresult, an overload condition can be avoided, or at least partiallyameliorated.

In various alternative embodiments, referring now to FIGS. 29 and 30, analternative surgical instrument 100″ can comprise a one piece trigger170″ which can drive the first drive system and the second drive systemdescribed above. More particularly, in at least one embodiment, thetrigger 170″ can be, similar to the above, configured to be rotatedbetween an actuated position and an unactuated position about pivot 171during a stroke of trigger 170″. Also similar to the above, this strokeof trigger 170″ can comprise a first range of motion for driving thefirst drive system and a second range of motion for driving the seconddrive system. Referring to FIG. 29, the trigger 170″ is illustrated inan unactuated position wherein trigger gear teeth 178″ are not operablyengaged with compounding gear 191 and the toggle clamp 180 is in itsfirst, or unactuated, configuration. During the first range of motion oftrigger 170″, referring now to FIG. 30, the trigger 170″ can move thetoggle clamp 180 from its first configuration into its secondconfiguration, similar to the above, and, in addition, operably engagetrigger gear teeth 178″ with compounding gear 191. During the secondrange of motion of trigger 170″, similar to the above, the trigger 170″can rotate compounding gear 191 to advance rack 160 and cutting member140 and, as trigger 170″ is no longer operably engaged with toggle clamp180, the trigger 170″ can move relative to first link 182. When trigger170″ is released, similar to the above, the surgical instrument 100″ cancomprise a spring which can bias toggle clamp 180 back into its firstconfiguration and return trigger 170″ to its unactuated position. Thesurgical instrument 100″ can further comprise a second spring which canreverse the rotation of compounding gear 191 to return the rack 160 andcutting member 140 to their initial, or starting, positions. In variousembodiments, the trigger 170″ can further comprise a return tooth 178″which can be configured to engage compounding gear 191 and assure thatcompounding gear 191, rack 160, and cutting member 140 are returned totheir initial, or starting, positions as trigger 170″ is moved into itsunactuated position as illustrated in FIG. 29.

As described above, in various embodiments, the trigger assembly 120 cancomprise a button 122 for actuating switch 123, wherein switch 123 ismounted to first link 124, wherein first link 124 is operably engagedwith second link 126, and wherein second link 126 is configured torotate lock 150. Referring now to the embodiment illustrated in FIG. 45,a surgical instrument can comprise a trigger assembly 720 comprising,similar to the above, a switch 723 mounted to a link 724, wherein theswitch 723 can comprise a button 722 configured to actuate switch 723.In various embodiments, button 722 and switch 723 can operate insubstantially the same manner as button 122 and switch 123; however, inat least one embodiment, the link 724 of trigger assembly 720 may beconfigured such that it can engage lock 750 directly, i.e., without thepresence of a second link, such as second link 126, for example,operably positioned therebetween. In at least one such embodiment, aforce F can be applied to button 722 in order to actuate the switch 723and, simultaneously, rotate link 724 about pivot 718 in a directionindicated by arrow Z. In such circumstances, a drive end 751 of the link724 can contact lock 750 and rotate lock 750 about pivot pin 752 of yoke754 in a direction indicated by arrow Y. In various embodiments, furtherto the above, the force sufficient to actuate switch 723 may besufficient to move lock 750 from its locked position (FIG. 45), in whichlock tooth 755 is positioned within recess 762 in rack 760, into anunlocked position in which rack 760 can move relative to lock 750 andyoke 754. In at least one such embodiment, similar to the above, thestiffness of a spring within switch 723 and the stiffness of spring 721,positioned intermediate link 724 and handle frame 712, can be selectedsuch that switch 723 is actuated at the same time, or at leastsubstantially the same time, as rack 760 is unlocked. In various otherembodiments, also similar to the above, the stiffness of spring 721 andthe spring of switch 723 can be selected such that switch 723 can beactuated without moving lock 750 into an unlocked configuration. In suchembodiments, a second, or larger, force could be applied to button 722in order to unlock lock 750. In various alternative embodiments, thelock can include a lock spring configured to bias the lock 750 into alocked configuration and, in at least one embodiment, the lock springcan be used in lieu of spring 721, for example.

Referring now to the embodiment of FIG. 46, a surgical instrument cancomprise a trigger assembly 820 comprising, similar to the above, aswitch 823 comprising a button 822, wherein the switch 823 is mounted toa first link 824, and wherein upon an application of a force F to button820, the force can rotate link 824 about pivot 818 in a directionindicated by arrow X. As illustrated in FIG. 46, the trigger assembly820 can further comprise a slider 826 which is operably engaged withfirst link 824 such that, as link 824 is rotated in direction X, link824 can drive slider 826 upwardly in a direction indicated by arrow Wwithin a slot defined by handle portion 812. When slider 826 is movedupwardly, a drive end 851 of slider 826 can pass through a slot 869 inrack 860 in order to engage lock 850 and lift it upwardly out of recess862 in rack 860. In various embodiments, further to the above, thetrigger assembly 820 can further comprise a lock spring 856 positionedintermediate the lock 850, for example, and the handle frame 812 whereinthe lock spring 856 can be configured to bias lock 850 into recess 862.In certain embodiments, similar to the above, the switch 823 cancomprise a spring wherein the stiffness of the switch spring and thelock spring 856 can be selected such that the force sufficient toactuate switch 823 can be sufficient to move lock 850 into an unlockedposition and, as a result, unlock rack 860. In various alternativeembodiments, also similar to the above, the spring of switch 823 andlock spring 856 can be selected such that switch 823 can be actuatedwithout moving lock 850 into an unlocked position. In such embodiments,a second, or larger, force could be applied to button 822 in order tounlock lock 850.

In various embodiments, as described above, the end effector 106 ofsurgical instrument 100 can comprise an electrode 130 which, inco-operation with a ground or return electrode, can allow current toflow through tissue positioned within the end effector 106. In variouscircumstances, as also described above, the current flowing through theelectrode 130 can generate heat within the electrode 130 in order toseal the tissue, for example. In at least one embodiment, the electrode130 can be securely positioned within the first jaw 108, for example,such that the electrode 130 does not move relative to the first jaw 108.In addition to the above, the jaw 108 can comprise one or moreinsulators positioned intermediate the electrode 130 and the returnelectrode, wherein the insulators can assure that current does not flowdirectly between the electrode 130 and the return electrode without atleast first passing through the tissue. In various alternativeembodiments, referring now to FIG. 39, an alternative surgicalinstrument can comprise an electrode 530 which can be moved relative toan insulator 532 and/or a return 534, for example. In at least oneembodiment, the electrode 530 can comprise a top surface, ortissue-contacting surface, 531 which can be configured to be positionedagainst the tissue T positioned within the end effector 506. In variouscircumstances, the top surface 531 of electrode 530 can be raised and/orlowered with respect to the insulator 532 and/or return 534. Moreparticularly, in at least one such embodiment, the top surface 531 ofelectrode 530 can be moved relative to the top surfaces 533 a and 533 bof insulator 532 and/or relative to the top surfaces 535 a and 535 b ofreturn 534. In various circumstances, raising the electrode 530, or topsurface 531, relative to the insulator 532 and/or return 534 canincrease the amount of tissue exposed to the electrode 530. In suchcircumstances, the size of the seal created within the tissue can beincreased as compared to when the electrode 530 is in a lower position,for example. When the electrode 530 is lowered, the size of the sealcreated within the tissue can be decreased as compared to when theelectrode 530 is in a raised position, for example. In variouscircumstances, when the electrode 530 is in a lower position, thelateral spread of heat to tissue adjacent the end effector 506 can bereduced as compared to when the electrode 530 is in a raised position.

In various embodiments, further to the above, a surgical instrument cancomprise means for lifting and/or lowering electrode 530 relative toinsulator 532. In at least one embodiment, the electrode 530 cancomprise a bottom surface comprising a ramp or inclined surface,wherein, when the electrode 530 is slid longitudinally within the endeffector 506, the inclined surface can contact a cam within the endeffector 506 such that the electrode 530 is lifted upwardly, i.e., in adirection which is orthogonal, or at least substantially orthogonal, toa plane defined by one of top surfaces 531, 533 a, 533 b, 535 a, and/or535 b, for example. In other circumstances, the electrode 530 can belowered downwardly relative to the plane when the electrode 530 is slidor pulled down the cam. In various embodiments, the end effector 506 cancomprise two or more electrodes which can be raised and/or loweredtogether or independently. In embodiments where the electrodes areraised or lowered together, the surgical instrument can comprise anactuator which moves the electrodes longitudinally within the endeffector at the same time. In embodiments where the electrodes can beraised and/or lowered independently, the surgical instrument cancomprise two or more actuators which can be actuated independently inorder to independently move the electrodes. In various otherembodiments, a surgical instrument can comprise one or more driverscomprising an inclined surface which are slid under the electrodes in alongitudinal direction and, depending on the direction the drivers areslid, the drivers can raise or lower the electrodes.

In various alternative embodiments, referring now to FIG. 40, an endeffector 606 can comprise an electrode 630, a first insulator 632 apositioned on a first side of electrode 630, a second insulator 632 bpositioned on a second side of electrode 630, a first return 634 apositioned adjacent to first insulator 632 a, and a second return 634 bpositioned adjacent to second insulator 632 b. The end effector 606 canfurther comprise a first actuator 636 a operably coupled to firstinsulator 632 a, wherein the first actuator 636 a can be configured toslide first insulator 632 a up and/or down ramp, or cam, 637. Similarly,the end effector 606 can further comprise a second actuator 636 boperably coupled to second insulator 632 b, wherein the second actuator636 b can be configured to slide second insulator 632 b up and/or downramp, or cam, 637. As illustrated in FIG. 40, the second insulator 632 bcan comprise an inclined bottom surface 638 b which can co-operate withthe inclined surface of cam 673 in order to move top surface 633 b ofsecond insulator 632 b relative to the top surface 631 of electrode 630and/or the top surface 635 b of return 634 b, for example. Similarly,the first insulator 632 a can comprise an inclined bottom surface whichcan co-operate with the inclined surface of cam 673 in order to move topsurface 633 a of first insulator 632 a relative to the top surface 631of electrode 630 and/or the top surface 635 a of return 634 a, forexample. Various other embodiments are envisioned in which one or morereturns can be raised and/or lowered relative to an electrode, forexample.

The embodiments of the devices described herein may be introduced insidea patient using minimally invasive or open surgical techniques. In someinstances it may be advantageous to introduce the devices inside thepatient using a combination of minimally invasive and open surgicaltechniques. Minimally invasive techniques may provide more accurate andeffective access to the treatment region for diagnostic and treatmentprocedures. To reach internal treatment regions within the patient, thedevices described herein may be inserted through natural openings of thebody such as the mouth, anus, and/or vagina, for example. Minimallyinvasive procedures performed by the introduction of various medicaldevices into the patient through a natural opening of the patient areknown in the art as NOTES™ procedures. Some portions of the devices maybe introduced to the tissue treatment region percutaneously or throughsmall-keyhole-incisions.

Endoscopic minimally invasive surgical and diagnostic medical proceduresare used to evaluate and treat internal organs by inserting a small tubeinto the body. The endoscope may have a rigid or a flexible tube. Aflexible endoscope may be introduced either through a natural bodyopening (e.g., mouth, anus, and/or vagina) or via a trocar through arelatively small-keyhole-incision incisions (usually 0.5-1.5 cm). Theendoscope can be used to observe surface conditions of internal organs,including abnormal or diseased tissue such as lesions and other surfaceconditions and capture images for visual inspection and photography. Theendoscope may be adapted and configured with working channels forintroducing medical instruments to the treatment region for takingbiopsies, retrieving foreign objects, and/or performing surgicalprocedures.

Preferably, the various embodiments of the devices described herein willbe processed before surgery. First, a new or used instrument is obtainedand if necessary cleaned. The instrument can then be sterilized. In onesterilization technique, the instrument is placed in a closed and sealedcontainer, such as a plastic or TYVEK® bag. The container and instrumentare then placed in a field of radiation that can penetrate thecontainer, such as gamma radiation, x-rays, or high-energy electrons.The radiation kills bacteria on the instrument and in the container. Thesterilized instrument can then be stored in the sterile container. Thesealed container keeps the instrument sterile until it is opened in themedical facility. Other sterilization techniques can be done by anynumber of ways known to those skilled in the art including beta or gammaradiation, ethylene oxide, and/or steam.

Although the various embodiments of the devices have been describedherein in connection with certain disclosed embodiments, manymodifications and variations to those embodiments may be implemented.For example, different types of end effectors may be employed. Also,where materials are disclosed for certain components, other materialsmay be used. The foregoing description and following claims are intendedto cover all such modification and variations.

Any patent, publication, or other disclosure material, in whole or inpart, that is said to be incorporated by reference herein isincorporated herein only to the extent that the incorporated materialsdoes not conflict with existing definitions, statements, or otherdisclosure material set forth in this disclosure. As such, and to theextent necessary, the disclosure as explicitly set forth hereinsupersedes any conflicting material incorporated herein by reference.Any material, or portion thereof, that is said to be incorporated byreference herein, but which conflicts with existing definitions,statements, or other disclosure material set forth herein will only beincorporated to the extent that no conflict arises between thatincorporated material and the existing disclosure material.

1. A surgical instrument for supplying energy to tissue, comprising: ahandle, comprising: a trigger; and an electrical input; a shaftextending from said handle, wherein said shaft comprises a conductor,wherein said trigger is selectively actuatable to electrically couplesaid electrical input and said conductor; and an end effector,comprising: a first jaw member, comprising: an electrode electricallycoupled with said conductor, wherein said electrode is configured togenerate heat when electrical energy is supplied to said electrode, andwherein said electrode comprises a top surface; and an insulatorpositioned adjacent to said electrode, wherein said insulator comprisesa top surface movable between a first position and a second positionrelative to said top surface of said electrode, and wherein said topsurface of said insulator is closer to said top surface of saidelectrode when said insulator is in said first position than when saidinsulator is in said second position; and a second jaw member, whereinat least one of said first jaw member and said second jaw member ismovable relative to the other of said first jaw member and said secondjaw member to clamp tissue intermediate said first jaw member and saidsecond jaw member.
 2. The surgical instrument of claim 1, wherein saidend effector further comprises a driver, and wherein said driver isslidable relative to said insulator in order to move said insulatorbetween said first position and said second position.
 3. The surgicalinstrument of claim 1, wherein said insulator comprises a firstinsulator positioned adjacent to a first side of said electrode, whereinsaid end effector further comprises a second insulator positionedadjacent to a second side of said electrode, and wherein said secondinsulator is movable between a third position and a fourth positionrelative to said top surface of said electrode.
 4. The surgicalinstrument of claim 3, wherein said end effector further comprises adriver, wherein said driver is slidable relative to said first insulatorin order to move said first insulator between said first position andsaid second position, and wherein said driver is slidable relative tosaid second insulator in order to move said second insulator betweensaid third position and said fourth position.
 5. The surgical instrumentof claim 1, wherein said insulator moves in a first direction when itmoves between said first position and said second position, and whereinsaid first direction is transverse to a plane defined by said topsurface of said electrode.
 6. The surgical instrument of claim 5,wherein said insulator comprises a cam, wherein said end effectorcomprises an end effector body, wherein said cam is configured tooperably engage said end effector body such that when said insulator ismoved in a second direction said insulator is moved in said firstdirection.
 7. A surgical instrument for supplying energy to tissue,comprising: a handle, comprising: a trigger; and an electrical input; ashaft extending from said handle, wherein said shaft comprises aconductor, wherein said trigger is selectively actuatable toelectrically couple said electrical input and said conductor; and an endeffector, comprising: a first jaw member, comprising: an electrodeelectrically coupled with said conductor, wherein said electrode isconfigured to generate heat when electrical energy is supplied to saidelectrode, and wherein said electrode comprises a tissue-contactingsurface; and an insulator positioned adjacent to said electrode, whereinsaid insulator is movable relative to said tissue-contacting surfacebetween a first height and a second height, and wherein said insulatoris positioned closer to said tissue-contacting surface when saidinsulator is at said first height than when said insulator is at saidsecond height; and a second jaw member, wherein at least one of saidfirst jaw member and said second jaw member is movable relative to theother of said first jaw member and said second jaw member to clamptissue intermediate said first jaw member and said second jaw member. 8.The surgical instrument of claim 7, wherein said end effector furthercomprises a driver, and wherein said driver is slidable relative to saidinsulator in order to move said insulator between said first height andsaid second height.
 9. The surgical instrument of claim 7, wherein saidinsulator comprises a first insulator positioned adjacent to a firstside of said electrode, wherein said end effector further comprises asecond insulator positioned adjacent to a second side of said electrode,and wherein said second insulator is movable between a third height anda fourth height relative to said tissue-contacting surface.
 10. Thesurgical instrument of claim 9, wherein said end effector furthercomprises a driver, wherein said driver is slidable relative to saidfirst insulator in order to move said first insulator between said firstheight and said second height, and wherein said driver is slidablerelative to said second insulator in order to move said second insulatorbetween said third height and said fourth height.
 11. The surgicalinstrument of claim 7, wherein said insulator moves in a first directionwhen it moves between said first height and said second height, andwherein said first direction is transverse to a plane defined by saidtissue-contacting surface of said electrode.
 12. The surgical instrumentof claim 11, wherein said insulator comprises a cam, wherein said endeffector comprises an end effector body, wherein said cam is configuredto operably engage said end effector body such that when said insulatoris moved in a second direction said insulator is moved in said firstdirection.
 13. A surgical instrument for supplying energy to tissue,comprising: a handle, comprising: a trigger; and an electrical input; ashaft extending from said handle, wherein said shaft comprises aconductor, wherein said trigger is selectively actuatable toelectrically couple said electrical input and said conductor; and an endeffector, comprising: a first jaw member, comprising: an electrodeelectrically coupled with said conductor, wherein said electrode isconfigured to generate heat when electrical energy is supplied to saidelectrode, and wherein said electrode comprises a top surface; and aninsulator positioned adjacent to said electrode, wherein said insulatorcomprises a top surface, wherein said top surface of said electrode ismovable between a first position and a second position relative to saidtop surface of said insulator, and wherein said top surface of saidelectrode is closer to said top surface of said insulator when saidelectrode is in said first position than when said electrode is in saidsecond position; and a second jaw member, wherein at least one of saidfirst jaw member and said second jaw member is movable relative to theother of said first jaw member and said second jaw member to clamptissue intermediate said first jaw member and said second jaw member.14. The surgical instrument of claim 13, wherein said end effectorfurther comprises a driver, and wherein said driver is slidable relativeto said electrode in order to move said electrode between said firstposition and said second position.
 15. The surgical instrument of claim13, wherein said electrode comprises a first electrode, wherein said endeffector further comprises a second electrode, and wherein said secondelectrode is movable between a third position and a fourth positionrelative to said top surface of said insulator.
 16. The surgicalinstrument of claim 15, wherein said end effector further comprises adriver, wherein said driver is slidable relative to said first electrodein order to move said first electrode between said first position andsaid second position, and wherein said driver is slidable relative tosaid second electrode in order to move said second electrode betweensaid third position and said fourth position.
 17. The surgicalinstrument of claim 13, wherein said electrode moves in a firstdirection when it moves between said first position and said secondposition, and wherein said first direction is transverse to a planedefined by said top surface of said insulator.
 18. The surgicalinstrument of claim 17, wherein said electrode comprises a cam, whereinsaid end effector comprises an end effector body, wherein said cam isconfigured to operably engage said end effector body such that when saidelectrode is moved in a second direction said electrode is moved in saidfirst direction.